title: Hepatitis E virus infection as a new probable cause of de novo membranous nephropathy after kidney transplantation.
abstract: Hepatitis E virus (HEV) has been identified as a cause of chronic viral hepatitis in immunocompromised patients. Some glomerular diseases were found to be associated with this infection. We report the first case, to our knowledge, of a kidney transplant recipient who developed an HEV infection and de novo membranous nephropathy (MN) concomitantly. The patient displayed a hepatic cytolysis first and a nephrotic syndrome occurred 3 months later. HEV infection was diagnosed upon positive polymerase chain reaction on plasma and stool samples, and renal allograft biopsy revealed de novo MN. Typical causes of MN were definitively excluded. A 3-month course of ribavirin monotherapy allowed the patient to mount a sustained viral response that was rapidly followed by complete remission of the nephrotic syndrome. The chronology of the onset and remission of both diseases is highly suggestive of a causal relationship between hepatitis E and MN.
authors.affiliation: Nephrology-Transplantation, CHU de Bordeaux, Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Taton
authors.forename: K
authors.initials: K
authors.lastname: Moreau
authors.forename: S
authors.initials: S
authors.lastname: Lepreux
authors.forename: T
authors.initials: T
authors.lastname: Bachelet
authors.forename: P
authors.initials: P
authors.lastname: Trimoulet
authors.forename: V
authors.initials: V
authors.lastname: De Ledinghen
authors.forename: A
authors.initials: A
authors.lastname: Pommereau
authors.forename: P
authors.initials: P
authors.lastname: Ronco
authors.forename: N
authors.initials: N
authors.lastname: Kamar
authors.forename: P
authors.initials: P
authors.lastname: Merville
authors.forename: L
authors.initials: L
authors.lastname: Couzi
mesh_terms: D015433:Glomerulonephritis, Membranous / Q000821:virology*; D016751:Hepatitis E / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged
keywords: hepatitis E virus; kidney transplantation; membranous nephropathy; ribavirin